A patient was diagnosed with hiatal hernia. She frequently has regurgitation and a sour taste on his mouth especially after eating large meals. Which action by the client shows understanding of her treatment regimen?

Correct Answer: D

Rationale: The correct answer is D: avoid caffeine, alcohol, and chocolate. This helps to reduce acid reflux symptoms associated with hiatal hernia. Caffeine, alcohol, and chocolate can relax the lower esophageal sphincter, leading to increased reflux. Elevating legs (choice A) does not address the underlying issue. Drinking more fluids (choice B) can exacerbate symptoms by increasing stomach volume. Increasing roughage (choice C) may worsen symptoms due to increased gastric distension. By avoiding triggers like caffeine, alcohol, and chocolate, the client can effectively manage her symptoms.

Correct Answer: C

Rationale: Step-by-step rationale for choice C being correct: 1. Restlessness: Indicates increased work of breathing and hypoxia. 2. Suprasternal retractions: Sign of respiratory distress. 3. paO2 of 62: Indicates severe hypoxemia, common in ARDS. Summary: A: Enlarged heart on x-ray does not directly indicate ARDS. B: Thick green sputum suggests infection, not specific to ARDS. D: Wheezes and slow respirations are not typical of ARDS, and pCO2 is normal in ARDS.

Correct Answer: B

Rationale: The correct answer is B: inadequate supply of oxygen to the myocardium. Angina pectoris is chest pain or discomfort caused by reduced blood flow to the heart muscle. This lack of oxygenated blood supply to the myocardium leads to ischemia, resulting in the characteristic chest pain. Choice A is incorrect as it refers to a decrease in alveolar surface area for gas exchange, which is related to conditions like emphysema, not angina. Choice C is incorrect as it pertains to pulmonary circulation, not coronary circulation. Choice D is incorrect as an increase in alveolar surface area would not be a cause of angina pectoris.

Correct Answer: B

Rationale: The correct answer is B because hyperkalemia presents with symptoms such as muscle weakness, diarrhea, and ECG changes. Muscle weakness is a common sign due to potassium's effect on neuromuscular function. Diarrhea can lead to potassium loss. ECG changes, such as peaked T waves and widened QRS complexes, indicate cardiac involvement. Assessing for these symptoms helps monitor the severity of hyperkalemia and guide treatment. Other choices are incorrect because assessing for fever and chest pain (choice A) are not specific to hyperkalemia. Encouraging fluid restriction (choice C) may not directly address hyperkalemia. Preparing for a cardiac ultrasound (choice D) is not an immediate intervention for hyperkalemia.

Correct Answer: D

Rationale: The correct answer is D. In Addison's disease, the adrenal glands do not produce enough cortisol and aldosterone. This leads to sodium and potassium imbalances. Low aldosterone causes sodium loss and potassium retention, resulting in sodium and potassium abnormalities. The other choices, A, B, and C, do not directly relate to Addison's disease. Calcium and phosphorus abnormalities are not typically associated with Addison's disease. Sodium and chloride, and chloride and magnesium imbalances are not primary concerns in Addison's disease. Therefore, staying alert for signs and symptoms of sodium and potassium abnormalities is crucial in managing and monitoring a client with Addison's disease.